As Ye Sow . . .
A number of years ago, the Chrysler Corporation had an aggressive marketing campaign that failed because it did not have a high-quality product. At about the same time, Digital Equipment Corporation started going downhill because of overdependence on high quality to the neglect of marketing. Today the news is full of horror stories of corporations that diversified into fields in which they had no expertise and brought death and destruction to the originally strong parent company.
To continue the metaphor, the General Motors Company chose Mr. Goodwrench as its symbol of service quality. The problem was that it was competing with Japanese automobile companies that were practicing zero-defect manufacturing, companies whose standards were so high that they were subjecting U.S. cars imported into Japan to rigorous servicing before placing them on their sales floors. Not only that, GM didn't have a Mr. Goodwrench, as almost any owner of a GM car could attest. In other words, GM had a false image, and it is still paying for it even after making significant improvement in its products.
All this could serve as a reminder to orthodontists. Orthodontic practices need balance. Almost all orthodontists believe that their treatment and treatment results are above average. But even if "average" among today's orthodontists is a high mark, that average could still be raised higher by a rigorous evaluation process. Self-evaluation is one of the privileges of our system. Part of our covenant with the public is that we conduct such evaluation, and that there are well-founded standards of quality in orthodontics. We may not fully achieve it, but we may at least approach zero-defect orthodontics.
Orthodontists are correct to assume that high quality of treatment results is essential to their success. They are incorrect to assume that it is all that is required. Not many practices remain successful throughout their lifetime without recognizing this fact. Too many orthodontists have seen their practices go downhill after 15 or so years of practice as a direct result of this kind of thinking. Practice building is a constant need.
However, practice building is not a standardized endeavor. Practices that are highly successful and practices that are much less successful apply most of the practice-building methods in almost equal measure, according to the 1991 JCO Orthodontic Practice Study. Yet the more successful practices invariably report a higher degree of effectiveness for most of the methods. One would have to think that the more successful practices use these measures in a planned, organized, concerted effort involving staff, patients, and parents.
Unless time is set aside for actively planning practice building, it will be about as effective as throwing darts blindfolded. Time outside of patient treatment hours is needed to evaluate the practice's resources, needs, and goals, and to effectively formulate a plan for organized practice building. The quality of the practice building must match the quality of the treatment.
The corporate experience with unqualified diversification ought also to remind us that the quality of orthodontic services must itself be balanced. If we undertake TMJ treatment, or functional appliances, or lingual orthodontics, the quality of all of these must be equal to the high standards we set for ourselves in fixed, labial orthodontics. Any diminution of quality, even in areas that are peripheral to most practices, dilutes the overall quality and can be damaging to practice success.
There is much to be learned by paying attention to the experience of others, even in endeavors as remote from orthodontic practice as automobile manufacturing. While there are vast differences between large corporations and orthodontic practices, there are also common denominators, and nowhere more importantly than in quality of products and services. Both types of enterprise are involved in production, sales, R & D, quality control, personnel management, and administrative management. For both, high-quality performance in all of these areas is essential for a high level of success. Still, we have one big advantage over a GM: A single individual is usually the decision-maker in orthodontic practice, and decisions can be made and implemented immediately. The challenge--whether one manufactures automobiles or straightens teeth--lies in making the right decisions.